Summary
A study of the cytomorphological aspects and cytohistological correlations in pre-neoplastic alterations and malignant tumours of gastric mucosa has been carried out by the authors on 1 448 cases of gastric pathology observed on a total of 5 154 gastroscopies performed from 1971 to 1979.
Cytohistological correlations have been evaluated on the whole case history by classifying the cytological findings through morphological criteria as follows: normal aspects — inflammatory changes, hyper-regenerative changes, atrophic changes, from intestinal metaplasia changes, dysplasia (slight, moderate, severe) and malignant alteration.
The sensitivity, specificity, rates of false-positive and false-negatives both in cytology and in cytology plus biopsy have been evaluated on 379 cases whose cytological correlations have been worked out on surgical material. The diagnostic accuracy of cytology and of cytology plus biopsy has proved remarkably high both in early cancer and advanced cancer as well as in precancerous conditions and lesions. The data show that employing cytological examination through brushing during endoscopic investigation, associated with aimed biopsy, increases diagnostic accuracy in pre-cancerous lesions and conditions, in early gastric cancer as well as advanced ones, and it proves useful in surveying the pre-cancerous lesions-cancer sequence.
Résumé
Une étude des aspects cyto-morphologiques et des corrélations cyto-histologiques dans les altérations prénéoplasiques et les tumeurs malignes de la muqueuse gastrique a été menée par les auteurs sur 1 448 cas de pathologie gastrique observés sur un total de 5 154 gastroscopies réalisées de 1971 à 1979.
Les corrélations cyto-histologiques ont été évaluées pour tous les cas par une classification des découvertes cytologiques selon les critères morphologiques suivants: aspects normaux-modifications inflammatoires, modifications hyperrégénératives, modifications atrophiques, des modifications de la métaplasie intestinale, puis de la dysplasie (légère, modérée, sévère) jusqu'aux, altérations malignes.
La sensibilité, la spécificité, les taux de faux positifs, et faux négatifs tant de la cytologie que de la cytologiebiopsie ont été évaluées sur 379 cas pour lesquels les corrélations cytologiques ont été établies à partir d'un matériel chirurgical. La précision diagnostique de la cytologie et de la cytologie-biopsie s'est avérée remarquable aussi bien pour les cancers précoces et les cancers avancés que pour les états et lésions pré-néoplasiques. Les résultats montrent que l'examen cytologique par brossage durant l'investigation endoscopique associé à une biopsie dirigée augmente l'efficacité diagnostique dans les lésions et états pré-cancéreux, dans le cancer gastrique au début ou à un stade plus avancé et témoignent de son importance dans la surveillance de la séquence lésions pré-cancéreuses/cancer.
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Amadori, D., Ravaioli, A., Saragoni, A. et al. Cyto-morphological aspects and cyto-histological correlations in pre-neoplastic alterations and in malignancies of gastric mucosa. Acta Endosc 11, 155–169 (1981). https://doi.org/10.1007/BF02967289
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DOI: https://doi.org/10.1007/BF02967289